Volume 1

A system of medicine / edited by J. Russell Reynolds.

Date:
1866-1879
Catalogue details

Licence: Public Domain Mark

Credit: A system of medicine / edited by J. Russell Reynolds. Source: Wellcome Collection.

    142/976 (page 122)
    It also promotes free action of the skin, and exercises a sedative action on the circulation, “ In fine,” says Dr. Ewart, “ ipecacuanha in large doses, may he said to fulfil many indications. “ It produces all the good effects that have been ascribed to blood- letting without robbing the system of one drop of blood, of mercurial and other purgatives without their irritating action, of antimonials and sudorifics without their uncertainty, and of opium without masking the disease.” I may add, that “it is the most' simple, the most successful, the most conservative and the least distressing mode of treatment I have ever seen used in dysentery. Year by year under its use the number of chronic cases is becoming smaller, and hepatic abscess as a complication is less frequently seen. Although most effective in the early stage of the acute form, it may be given at a much later period with advantage, and even in chronic cases, where from any cause sub-acute symptoms have set in, I often give it with the best results. Some authors caution us against its use in large doses in adynamic cases, and doubtless in such cases very large doses are not advisable. Still, I have used it even where the powers of life were very low, and with the best effect. I well remember the case of a lady, sent to Madras from Calcutta, who landed in such a state of exhaustion that it was with difficulty I could hear her voice. With some misgivings, the symptoms being urgent and the case critical, I gave twenty-grain doses of ipecacuanha at intervals of eight hours, interposing support between the doses ; after the thud dose this lady was out of danger, and made a rapid recovery. If unmanageable vomiting follows the use of ipecacuanha, hepatic complication of a serious kind may be suspected—or the vomiting may arise from the system being overcharged with malaria, severe gastric symptoms of this kind being extremely common in remittent fever. As soon as the disease abates, the dose of the remedy should be abated also. It is well, however, for some days to administer ten or twelve grains at bedtime, for a night or two after the stools are to all appearance healthy. Fomentations, stupes with turpentine, or the application of strong chloroform liniment to the abdomen help to lessen tormina and diminish suffering. If a little diarrhoea, without the dysenteric odours remain, it may be checked with a little astringent mixture, such as the compound chalk powder, with or Without opium. Astringents in any shape during the acute stage are not only useless but dangerous. In Malarious Dysentery quinine in full doses should be given, not less than a scruple in solution some time before the ipecacuanha, and repeated until cinchonism, as evidenced by ringing in the ears, is induced. Ipecacuanha and quinine should be given in alternate doses until the characteristic effects of both are produced. In the malignant dysentery of camps our utmost efforts must be directed to improve the hygienic conditions of the sick, and in addition to the means already mentioned carefully modified to suit the condition of